Healthy Eating For Women

Breast cancer. Osteoporosis. Iron deficiency. Weight reduction. What do these things have in common? They are either unique to women, or are more prevalent in women. And they affect current recommendations on what women should eat for optimum health. While new information on what's good and what's bad seems to surface almost daily, some basic guidelines have taken root over the past several years. The bottom line is: Eat a variety of foods Maintain healthy weight Choose a diet low in fat, saturated fat, and cholesterol Choose a diet with plenty of vegetables, fruits, and grain products Use sugar and salt/sodium only in moderation If you drink alcoholic beverages, do so in moderation. That sounds simple enough. Except, what exactly is variety? Cake one day, cookies the next? What is a diet low in fat, saturated fat, and cholesterol? And, finally, what parts of a healthy diet have special importance for women?

Vitamins and Minerals

There are several vitamins and minerals essential to a healthy diet. A well-balanced diet will usually meet women's allowances for them (see Recommended Dietary Allowances for Adults). However, for good health, women need to pay special attention to two minerals, calcium and iron.

Calcium

Both women and men need enough calcium to build peak (maximum) bone mass during their early years of life. Low calcium intake appears to be one important factor in the development of osteoporosis. Women have a greater risk than men of developing osteoporosis. A condition in which progressive loss of bone mass occurs with aging, osteoporosis causes the bones to be more susceptible to fracture. If a woman has a high level of bone mass when her skeleton matures, this may modify her risk of developing osteoporosis. Therefore, particularly during adolescence and early adulthood, women should increase their food sources of calcium. "The most important time to get a sufficient amount of calcium is while bone growth and consolidation are occurring, a period that continues until approximately age 30 to 35," says Marilyn Stephenson, a registered dietitian with FDA's Center for Food Safety and Applied Nutrition. "The idea is, if you can build a maximum peak of calcium deposits early on, this may delay fractures that occur later in life." In Singapore, the recommended dietary allowance (RDA) for calcium for woman 19 to 64 is 500 milligrams per day. The American RDA breaks it down for women 19 to 24 to have 1,200 mg of calcium; the allowance drops to 800 milligrams for women 25 and older. "That is still a significant amount." says Stephenson. "The need for good dietary sources of calcium continues throughout life," she says. How do you get enough calcium without too many calories and fat? After all, the foods that top the calcium charts--milk, cheese, ice cream--are also high in calorie and fat. There are lower fat choices such as HiLo or skim milk instead of homogenized (whole) milk, and lower fat cheeses, yoghurts, and ice milk. In addition to dairy foods, other good sources of calcium include fish with bones (ikan bilis or sardines), tofu (soybean curd), certain vegetables, dried peas and beans, seeds, and nuts.

Iron

For women, the RDA for iron is 11 milligrams per day, 5 milligrams more than the RDA for men. Women need more of this mineral because they lose an average of 15 to 20 milligrams of iron each month during menstruation. Without enough iron, iron deficiency anemia can develop and cause symptoms that include pallor, fatigue and headaches. After menopause, body iron stores generally begin to increase. Therefore, iron deficiency in women over 50 may indicate blood loss from another source, and should be checked by a physician. Animal products--meat, fish and poultry--are good and important sources of iron. In addition, the type of iron, known as heme iron, in these foods is well absorbed in the human intestine. Dietary iron from plant sources, called non-heme, are found in peas and beans, spinach and other green leafy vegetables, potatoes, and whole-grain and iron-fortified cereal products. Although non-heme iron is not as well absorbed as heme iron, the amount of non-heme iron absorbed from a meal is influenced by other constituents in the diet. The addition of even relatively small amounts of meat or foods containing vitamin C substantially increases the total amount of iron absorbed from the entire meal.

Calories and Weight Control

Weight control is often a concern for women. There is a lot of pressure in our society to be a certain body size; we see tall, underweight models splashed across the front page of glamour magazines suggesting that they should be the norm. Weight alone is not the only determinant of health, body shape, amount of fat to lean body mass, familial history, and other factors all contribute to your overall health. See section on Health Assessment to see how you rate. On the other hand, a woman's metabolism slows down from 2 to 8 percent every decade, which means women need 100 fewer calories a day than she did 10 years ago. It is no surprise then to find ourselves putting on weight even if we are eating the same or maybe less than before. Cutting back on calories is not always the answer to losing weight. It is important that you are meeting all your daily requirements for a healthy diet by having the minimum number of servings per day from the Healthy Diet Pyramid. If you find you are gaining weight, do not only focus on cutting calories, but also about increasing activity and exercise. Calories are only half of the equation for weight control. Physical activity burns calories, increases the proportion of lean to fat body mass, and raises your metabolism. Include strength-training and weight-bearing exercise in your routine to preserve bone density and combat the loss of muscle. So, a combination of both calorie control and increased physical activity is important for attaining healthy weight. If, however, you are been pigging out--well, you know what you have to do.

Folic Acid

Folate is important for women who are considering getting pregnant. Folic acid, the synthetic form of folate, a B vitamin protects fetuses from birth defects such as neural tube defects. Folate-deficient diets have also been linked to heart disease, colon cancer and dementia in the elderly. Good sources of folate include green, leafy vegetables, citrus fruits, folic acid-fortified cereal, and supplements. It is important to have enough folate even before you find out that you are pregnant because most of us do not find out that we are pregnant until a month into the pregnancy. It is in the first few weeks of fetal development that the folate is most important as the foundation for nerve generation is laid down.

Cholesterol & Fats

Women tend to have higher levels than men of a desirable type of cholesterol called HDLs (high-density lipoproteins) until menopause, leading some researchers to believe there is a link between HDLs and estrogen levels. But this does not let women off the hook--a diet high in saturated fat and cholesterol can still mean trouble. For both women and men, blood cholesterol levels of below 5.2 mmol/l (200 mg/dl) are desirable. Levels between 5.2-6.2 mmol/l (200-240 mg/dl) are considered borderline, and anything over 6.2 mmol/l (240 mg/dl) is high. High levels of blood cholesterol increase the risk of coronary heart disease. To keep levels in the good range, the Dietary Guidelines recommends eating no more than 300 milligrams of cholesterol a day. Cholesterol is found only in food from animal sources, such as egg yolks, dairy products, meat, poultry, shellfish, and--in smaller amounts--fish and some processed products containing animal foods. Even more important than limiting dietary cholesterol to under 300 milligrams is keeping saturated fat to under 10 percent of total calories. Saturated fat is found in fat on meats, full-fat dairy products, coconut milk & oil, lard, ghee and palm oil. Also follow general guidelines to keep total fat in the diet to less than 30% of total calories.

During Pregnancy

Your health and nutritional state before you become pregnant not only affect your ability to conceive but also the health of your baby and your own health down the road. To help ensure conception and delivery of a healthy baby and to protect your own health, you should get your weight into a healthy range even before trying to conceive. If you're undernourished and underweight, you may stop menstruating and become unable to conceive. If you do become pregnant while malnourished, you're starting off with inadequate stores of nutrients for both you and your baby. To lessen your chances of giving birth to a premature, underweight baby with a higher than normal risk of birth defects, it's important for you to start eating well before you decide to become pregnant. Overweight women also run the risk of developing more complications during pregnancy and tend to gain more weight than normal-weight women during pregnancy. If you're obese, you have a higher risk of developing high blood pressure or gestational diabetes, a form of diabetes that develops during pregnancy, usually disappears afterward and poses risks for both mother and baby. You may also deliver an overweight baby. If, however, you are overweight and do become pregnant, now is not the time to try losing weight. Instead, you'll have to work a little harder to gain no more than the appropriate amount of weight throughout your pregnancy.

Weight

Pregnant women who start off at a healthy weight are advised to gain 25 to 35 pounds. Underweight women may need to gain up to 40 pounds and overweight women only 15. Your doctor will tell you which end of the range you should aim for, depending on your age, height and weight when you become pregnant. You can determine if you are at a healthy weight pre-pregnancy by using the Body Mass Index calculator.

Energy (Calorie) Requirements

To get the all nutrients you need without overeating during pregnancy, choose your foods carefully. Stick to the Healthy Diet Pyramid but add 2 daily serving of milk and milk products (Meat & Alternatives Food group) in the first trimester. During the second and third trimesters, you need 300 extra calories a day, so add an extra serving from each of the four food group. Adequate energy intake is important for growth and development of the fetus and for the mother's ability to adapt to stresses such as infections or episodes of bleeding. Additional energy during pregnancy is required for the development of the baby and growth of maternal tissues, the additional metabolism the new tissues require, and the increased energy needed to move the added body tissue. Since a woman body increases about 20% during pregnancy, work involving a lot of movement will cost as much as 20% more in energy. Given these considerations, the total caloric cost of pregnancy has been calculated to be about 80,000 kcal or 300 calories per day. A further adjustment of energy requirement should be based on physical activity. Since energy expenditure varies so widely, the best index of adequate intake is a satisfactory weight gain. Since you also need extra protein, B-vitamins, vitamin D and minerals, such as calcium, phosphorus, iron and zinc, these 300 calories should come from nonfat milk and dairy products, lean meats, beans, whole grain breads and cereals, citrus fruits, dark green, leafy vegetables and other nutrient-rich foods. If you are a vegetarian, you should be especially careful about getting enough protein, iron and vitamin B-12 during pregnancy. Your doctor may prescribe or recommend a multivitamin-mineral supplement with iron to ensure that you meet your extra nutritional needs.

Protein Requirements

Complex new tissues are produced in pregnancy at a rate greater than at any other time during a woman's life. Protein is essential for this purpose, but during pregnancy protein requirements cannot be separated from needs for calories and other nutrients. As energy needs take first priority in metabolism during pregnancy, protein will be used for energy if carbohydrates and fat are not consumed in sufficient amounts. Conversely, increasing energy intake will improve utilization of protein. It is recommended that pregnant women consume an additional 10 grams of protein a day that is an extra 1½ ounce of meat, fish, poultry or in 2 cups of low-fat milk.

Vitamins and Minerals

Three vitamin in particular is of utmost importance during pregnancy: folate, iron & calcium. The role of folate has been discussed above. Talk to your doctor about supplementing the diet with folate if there is a question about adequate folate in the diet. Iron is needed during pregnancy for increased blood supply in the mother, as well as for the baby. For iron, small amounts of lean red meat are the best source, or combine beans, green leafy vegetables and iron-fortified or whole-grain cereals with vitamin C to improve absorption. Limit tea and coffee at mealtimes, as it can interfere with iron absorption. Calcium helps build bones for mother and child, so don't forget to include rich sources of calcium in your diet. Further, when unusual dietary practices or restrictions exist, other supplements may be needed. For women consuming a poor diet and for those in high risk categories--carrying more than one fetus, smoking heavily or using alcohol and drugs--a multivitamin-mineral preparation (containing iron, zinc, copper, calcium, vitamin B6, folate and vitamins C and D) is recommended.

Other Considerations

Artificial sweeteners are best avoided. There has been some debate about the safety of diet sodas and other foods that contain the artificial sweetener aspartame. While there is no evidence that aspartame is hazardous to pregnant women or their unborn babies, a mother-to-be is better off drinking milk, water and fruit juices than diet soda. Low-fat foods are always recommended, but pregnancy generally is not a time to use artificially sweetened diet foods. Caffeine may cause heartburn and nausea, but there is no convincing evidence that coffee or caffeine causes birth defects in humans. Still, many doctors recommend that pregnant women consume only moderate amounts of caffeine-containing beverages, such as coffee, tea, cola drinks, cocoa, etc. during their pregnancy because there is a suggestion that heavy and even moderate intake can lower infant birth weight. Alcohol can act as a potent agent on the young fetus. Fetal Alcohol Syndrome (FAS) was first described in 1973. Since then we have learned that there is a direct dose-response effect. While heavy drinking by alcohol abusers can result in FAS, lower levels of alcohol consumption can lead to fetal growth retardation. The data, although inconsistent, suggest that even one or two drinks per day can interfere with fetal growth. Smoking may affect maternal and fetal nutrition as well as produce harmful chemicals that result in a decrease in birth weight. The adverse effects are proportional to the frequency of smoking. Exercise during pregnancy is safe in the absence of medical or health conditions or problems that would preclude exercising. An exercise program can include large muscle exercises. You can exercise regularly -- 3 to 5 days a week. If in doubt or you experience any undesirable affects, stop and check with your doctor before continuing. Food cravings may be caused by hormonal changes in pregnancy, which can make some women more or less sensitive to tastes and smells. There is no evidence, however, that a craving indicates a need for any particular nutrient. If you crave pickles, for instance, it does not mean you need salt, and if you crave ice cream, you are not short on calcium. You may simply want the comfort associated with certain types of foods. If your cravings for junk food get out of hand, try to substitute foods that are more nutritious but similar in some way. If you're looking for something cool and creamy, have ice milk or low-fat frozen yogurt instead of ice cream. If you're looking for crunch, have baby carrots or unsalted pretzels instead of prawn crackers or potato chips. If you're looking for a sweet taste, have fresh, frozen, canned or dried fruit instead of candy, cake or cookies. Pica is an unusual, rare but serious condition that leads to cravings for foods that are not normally eaten, such as raw flour and cornstarch, and nonfoods including clay and paste. It may be related to an iron deficiency, and it also occurs in some pregnant women. Some people have even been known to crave toxic substances such as lead. If you find yourself craving unusual substances, call your doctor right away. Morning (noon and night) sickness is something of a misnomer for the nausea or vomiting that may occur in the early months of pregnancy at any time of day. It is probably caused by hormonal changes that upset the gastrointestinal tract. If you find yourself vomiting more than twice a day, call your doctor. To help you through this uncomfortable rite of passage: Eat smaller, more frequent meals, and do not let your stomach get empty. Avoid spicy and fried foods and eat plain, easy-to-digest foods, such as crackers, pasta, potatoes and rice. Drink fluids between meals, not with them--and not before breakfast. Eat a snack such as cereal with milk, cheese or fruit before going to bed at night. Eat a snack of crackers, dry toast or plain bisuit before you get out of bed. Get up slowly from bed; rushing is tough on your digestive system.